1. Field of the Invention
The present invention relates generally to surgical instruments and methods of their use, and, more particularly, to minimally invasive surgical instruments incorporating a needle and a retractor that can be extended through and beyond the needle and which can be retracted into the needle. The present invention has particular application to laparoscopic-type surgery, although it is not limited thereto.
2. Background Information
Over the last two decades, minimally invasive surgery has become the standard for many types of surgeries which were previously accomplished through open surgery. Minimally invasive surgery generally involves introducing an optical element (e.g., laparoscope or endoscope) through a surgical or natural port in the body, advancing one or more surgical instruments through additional ports or through the endoscope, conducting the surgery with the surgical instruments, and withdrawing the instruments and scope from the body. In laparoscopic surgery, a port for a scope is typically made using a surgical trocar assembly. The trocar assembly often includes a port, a sharp pointed element (trocar) extending through and beyond the distal end of the port, and at least in the case of abdominal laparoscopy, a valve on the proximal portion of the port. Typically, a small incision is made in the skin at a desired location in the patient. The trocar assembly, with the trocar extending out of the port is then forced through the incision, thereby widening the incision and permitting the port to extend through the incision, past any facie, and into the body (cavity). The trocar is then withdrawn, leaving the port in place. In certain circumstances, an insufflation element may be attached to the trocar port in order to insufflate the surgical site. An optical element may then be introduced through the trocar port. Additional ports are then typically made so that additional laparoscopic instruments may be introduced into the body.
Trocar assemblies are manufactured in different sizes. Typical trocar port sizes include 5 mm, 10 mm and 12 mm (available from companies such as Taut and U.S. Surgical), which are sized to permit variously sized laparoscopic instruments to be introduced therethrough including, e.g., graspers, dissectors, staplers, scissors, suction/irrigators, clamps, forceps, biopsy forceps, etc. While 5 mm trocar ports are relatively small, in some circumstances where internal working space is limited (e.g., children), it is difficult to place multiple 5 mm ports in the limited area. In addition, 5 mm trocar ports tend to limit movements of instruments inside the abdominal cavity to a great extent and, while relatively small, still leave holes that must be stitched and still result in undesired scarring.
One type of laparoscopic instrument used by surgeons is the retractor, which may be used for moving or manipulating body cavity tissue, particulate matter, and/or debris, where such uses may include retracting contents of the abdominal cavity, like the small bowel, stomach, colon. Available laparoscopic retractors include the retractable rake retractors. As an example, U.S. Pat. No. 6,743,237 to Dhindsa describes an endoscopic instrument having an extendable wire and also a collapsible rake element.
There remains, however, a need for further advancements in minimally invasive surgical instruments and procedures, and particularly, a need for a minimally invasive retractor instrument.